Subtotal Canine Prostatectomy with the Neodymium: Yttrium-Aluminum-Garnet Laser (original) (raw)
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Partial Prostatectomy Using Nd:YAG Laser for Management of Canine Prostate Carcinoma
Veterinary Surgery, 2006
Objective-To report a technique for partial prostatectomy by laser dissection and to evaluate outcome and complications in dogs with prostate carcinoma (PCA). Study Design-Experimental and clinical case series. Animals-Four normal dogs and 8 dogs with PCA. Methods-Subcapsular partial prostatectomy, sparing the urethra and the dorsal aspect of the prostatic capsule, using Nd:YAG laser dissection to remove the prostatic parenchyma and control hemorrhage was performed in 4 normal dogs and subsequently in 8 dogs with histologically confirmed PCA. Additional treatment of PCA dogs included local application of interleukin-2 and systemic administration of meloxicam. Prostate size, complications, and survival time were recorded. Laser-associated thermal damage to surrounding tissue was evaluated by histology. Results-In normal dogs, no damage to the dorsal prostatic capsule or urethra was detected. In PCA dogs, median survival was 103 days (range, 5-239 days). Three dogs died from complications within 16 days, whereas 5 (median survival, 183 days; range, 91-239 days) had improvement or resolution of clinical signs. Urinary incontinence did not occur. Conclusion-Laser assisted subcapsular partial prostatectomy can be performed in dogs with PCA without development of postoperative incontinence. Clinical Relevance-Subcapsular partial prostatectomy is a potential palliative treatment for PCA in dogs and may lead to the resolution of clinical signs for several months.
Pathologic changes occurring in the prostate following transurethral laser prostatectomy
Lasers in Surgery and Medicine, 1992
Serial gross and histopathologic examinations of the prostate following transurethral laser prostatectomy in the canine model demonstrated an immediate well-demarcated sphere of thermal necrosis measuring 2.7 cm in diameter, which, within 24 hours, had begun liquefaction and was showing multiple areas of cavitation. By the end of the 1st week, the areas of cavitation had coalesced to form a central cavity lined by a narrow layer of necrotic tissue clinging to the thin surviving peripheral belt of prostatic glandular parenchyma. At 3 weeks, the bluish-black discoloration resulting from breakdown of blood in the necrotic tissue had subsided, leaving masses of coagulonecrotic tissue within the central cavity. Within 5 weeks, the ectatic central cavity was lined by transitional epithelium. These postmortem pathologic observations confirm our surgical and clinical impressions of being able to satisfactorily perform an effective transurethral prostatectomy using neodymium:YAG (NdYAG) laser photoirradiation. o 1992 Wiley-Liss, Inc.
Urology, 1997
Objectives. We studied the safety and efficacy of 60-W potassium-titanyl-phosphate (KTP) laser prostatectomy in living dogs and compared the efficacy with that in fresh human and dog cadavers. Methods. Ten dogs underwent 60-W KTP laser prostatectomy and were sacrificed 3 hours (n = 5) or 7 weeks (n = 5) after operation. Two thawed fresh-frozen human cadaver prostates and two thawed fresh-frozen canine prostates were also vaporized with the 60-W KTP laser. All prostates were weighed, measured, serially sectioned, and whole mounted for histologic analysis. Results. In dogs, the in vivo procedure was hemostatic, and no irrigant absorption was detected. Prostatic defects with a mean diameter of 3.0 and 2.5 cm at 3 hours and 7 weeks postoperatively, respectively, were produced. With experience, resection time was reduced to 14 minutes. Of the 5 dogs that were studied for 7 weeks, 4 voided immediately after removal of the urethral catheter on the morning after operation, and 1 dog required recatheterization but voided with a strong stream when the urethral catheter was removed 4 days later. All 5 dogs were continent and had normal erectile function postoperatively.
Laser therapy in dogs and humans-is there a difference?
BJU International, 1997
Objective To compare quantitatively the reduction of their prostatic volume and necrosis assessed using transrectal ultrasonography. volume of benign prostatic hyperplasia (BPH) achieved by laser therapy in dogs and men. Results After laser treatment, the mean reduction in the dog prostate volume was 50% and in the patients was Patients, materials and methods Twelve mongrels, with a mean prostatic volume of 33.4 mL, underwent trans-only 21%. The different impact was probably caused by anatomical differences between the human and urethral laser treatment using an Nd5YAG laser with an UltralineA fibre at 60 W power setting. The dog prostate; the human prostate consists mainly of stromal tissue and the canine prostate of glandular reduction in prostatic volume was assessed quantitatively 3 months after treatment using stereological epithelium. Conclusions The canine model gives only an approximate methods. Forty patients (mean age 70.2 years, range 51-84) with symptomatic BPH (pre-operative mean guide to the extent of tissue destruction that laser treatment can achieve in men with BPH. Furthermore, prostate volume 46.3 mL) were treated under similar operative conditions with the same laser, power and tissue differences between men may also affect the response to laser treatment. fibre system. Their urinary performance was assessed before and 6 months after treatment using urinary Keywords Benign prostatic hyperplasia, volume reduction, laser therapy, dog, human flow rates, residual volume and a symptom score, and
Reproduction in Domestic Animals, 2020
Light-based technologies are applied in various fields of medicine: for example optical diagnostics, light-activated therapy and surgery. Although light-based surgical procedures had hardly been a novelty, the revolutionizing moment for surgery came with the first use of light to cut tissue. Nowadays, surgical lasers are routinely used across numerous medical specialties, including gynaecology and urology. They are a part of the surgical treatment of benign prostatic hyperplasia, prostate carcinoma, penis carcinoma, genital skin lesions and orchidectomy. While in human urology lasers How to cite this article: Tunikowska J, Prządka P, Kiełbowicz Z. Lasers in the surgical treatment of canine prostatic neoplasia and selected tumours of the male reproductive system.
Urology, 1998
Objectives. To directly compare holmium laser resection of the prostate (HoLRP) with neodymium:yttriumaluminum-garnet visual laser ablation of the prostate (VLAP), which represent two fundamentally different methods of laser prostatectomy. Methods. In a randomized, prospective comparison, a total of 44 men with symptomatic benign prostatic hyperplasia (BPH) were treated with either HoLRP or VLAP. Standard preoperative assessment included American Urological Association (AUA) symptom score, peak urinary flow rates (Qmax), ultrasound prostate volume, and residual urine measurements. Pressure-flow urodynamics were performed preoperatively and at 3 months postoperatively. Intraoperative and perioperative factors were assessed. The patients were followed at 1, 3, 6, and 12 months following the procedure. Results. There were no significant differences between the patient groups for any preoperative parameter. The mean total operating time was longer in the HoLRP group (52 minutes) compared with the VLAP group (41 minutes) (P Ͻ0.01). The mean catheter times were 1.4 days (HoLRP) and 11.6 days (VLAP) (P Ͻ0.001). These times included the 9% of patients undergoing HoLRP and 36% of patients undergoing VLAP who required recatheterization. Immediate postoperative dysuria scores were higher in the VLAP group compared with the HoLRP group. There were no significant differences in AUA scores between the two treatment groups at any postoperative interval. The Qmax values were greater at follow-up in the HoLRP group, but statistical significance was not achieved at 12 months. However, both PdetQmax and Schä fer grade measurements taken at 3 months postoperatively were significantly lower in the patients undergoing HoLRP. Three patients (14%) required reoperation in the VLAP treatment arm but no patient who underwent HoLRP has required reoperation to date. Conclusions. HoLRP results in significantly improved patient outcomes compared to VLAP. UROLOGY 51: 573-577, 1998.
Urodynamics and laser prostatectomy
World Journal of Urology, 1995
A total of 81 patients with symptomatic bladder-outlet obstruction (BOO) due to benign prostatic hyper plasia (BPH) underwent visual laser ablation of the prostate (VLAP) using a right-angled firing neodynium: YAG laser. The mean pre-operative prostatic volume was 48.5 ml. All patients were discharged on the 1st post-operative day with an indwelling catheter. Two patients underwent a trans urethral prostatectomy (TURP) after failing a trial without catheter on two occasions. O f the remaining 79 patients, 75 were evaluated 6 months post-operatively. Mean symp tom scores (I-PSS) decreased from 20,9 to 5.8, the mean maximal urinary flow rate increased from 7.9 to 16.4 ml/s and the mean residual volume decreased from 88.1 to 15.6 ml. Several different methods of evaluating BOO from pressure-flow measurements were used and all showed im provement. All the above-mentioned parameters showed a highly significant improvement (P <0.01) at 6 months.
Laser prostatectomy: Two and a half years' experience with aggressive multifocal therapy
Urology, 1996
Objectives. The aim of this study was to evaluate patient outcome 1 to 2 $ years after aggressive neodymium:yttrium-aluminum-garnet (Nd:YAG) laser prostatectomy alone or combined with potassium titanyl phosphate (KTP/532) laser therapy. Methods. In 32 men with symptomatic bladder outlet obstruction caused by benign prostatic hyperplasia, Nd:YAG laser energy (40 W) was delivered to six or more locations on the prostatic lateral lobes and one or more on the median lobe. In a subgroup of 15 of these patients, the prostate was also incised and sculpted with KTP/532 laser to create a better channel. Results. In the 32 men, voiding parameters improved: mean peak flow rate increased from 10 to 2 1 mL/s (1 1 O%), residual volume decreased from 167 to 64 mL (62%), and American Urological Association (AUA) symptom score decreased from 24 to 9 (63%). Catheters were removed after 3 days. Of the 17 patients treated with the Nd:YAG laser alone, 12 (70.5%) required recatheterization, whereas only 5 of the 15 (33%) who received KTP/532 laser therapy after Nd:YAG treatment required recatheterization (P co.00 1). In the entire group of 32 patients, complications included predictably prolonged retention (14 to 60 days) in 4 patients (12.5%) with hypotonic bladders, prolonged dysuria in 4 (12.5%), vesical neck contracture in 2 (6%), and significant hematuria in 1; none had incontinence. All 25 sexually active men remained potent (1 OO%), but among these patients retrograde ejaculation developed in 5 (20%). Conclusions. Aggressive Nd:YAG laser prostatectomy is safe and effective for obstructive prostates up to 70 mL in volume and produces good results that are sustained for up to 2 i years. Adjunctive KTP/532 laser therapy apparently creates an unobstructed channel more quickly and reduces the rate of postoperative retention, but it does not alter other voiding parameters. UROLOGY 48: 2 1996. From the Department of Urology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota.